Q: Am I correct that supervisors still complete POWER evals in addition to signing off on EPAs for PGY1s? Is there a way to integrate both somehow or streamline?

You are correct. Ultimately, the ITER will be transformed into an ITAR. They are not summative evals like the ITER, rather they pick up any pieces that may have been missed from other forms of assessment. They’re quick (generally less than 10 items). We need to establish that the EPAs are being done and actually represent something “real” before we make that switch. We’re essentially keeping the ITERs as a backup for the moment (to determine pass/fail) in case there are EPA problems. I would anticipate that the ITARs will start to roll out July 2019 and it will take a year or two to convert them all… it’s coming!

Q: What are coaches meant to do during the coaching sessions?

Coaches are asked to review all assessments (EPAs, ITERs, OSCE results, etc.) that the resident has received and work together on finding patterns/creating a learning plan.

Q: How are sites managing patients in the LAE on the days when the resident is not present? For example - what do sites do with patients in crisis, needing renewals, having questions on the 4 days when their resident is not in clinic?

The MRP is required to manage those issues.

Q: Are EPAs the only way that residents are assessed?

A: No – EPAs are one component. There are still many other methods of assessing residents, all of which are reviewed by the Competency Committee.

Assessment Tools

Q: Does a resident need to be observed in the encounter to complete the EPA tool?

A: For some EPAs, observation is essential. For others, the competency can be inferred from the presentation (e.g. reviewing the history or coming up with the diagnosis and plan).

Q: What is CBD?

A: See our overview of CBD.

Q: What is an EPA?

A: The definition and description of an EPA and each of the EPAs for the Transition to Discipline and Foundations of Discipline stages of competency can be found here.

Q: What are the stages of the competence continuum?

A: The stages of the competence continuum are illustrated in the graphic below. For the purposes of postgraduate education in psychiatry:

  • Transition to Discipline equates with the first month of PGY1 = Springboard.
  • Foundations of Discipline equates with the subsequent 23 months (the majority of PGY1 and PGY2).
  • Core of Discipline equates with PGY3 and PGY4.
  • Transition to Practice equates with PGY5.

Postgrad years

Q: How frequently do EPAs need to be observed?

A: Each resident needs an EPA to be observed about once per week.

Q: Is the EPA e-tool live now?

A: Yes, the EPA e-tool is live and ready for use! Residents have been trained and know how to access it and complete it.

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